49–010 

Calendar No. 290 

109TH CONGRESS REPORT " ! SENATE 1st Session 109–180 

VET CENTER ENHANCEMENT ACT OF 2005 

NOVEMBER 16, 2005.—Ordered to be printed 

Mr. CRAIG, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany S. 716] 

The Committee on Veterans’ Affairs (hereinafter, ‘‘the Committee’’), to which was referred the bill (S. 716), to amend title 38, 

United States Code, to enhance services provided by vet centers, to 

clarify and improve the provision of bereavement counseling by the 

Department of Veterans Affairs and for other purposes, (hereinafter ‘‘VA’’), having considered the same, reports favorably thereon, 

and recommends that the bill, do pass. 

INTRODUCTION

On April 6, 2005, Committee Ranking Member Daniel K. Akaka 

introduced S. 716, the Vet Center Enhancement Act of 2005 on behalf of himself, Committee member John D. Rockefeller, IV, and 

Senator Kent Conrad. The bill as introduced and ordered reported: 

authorizes the employment of as many as 50 veterans of Operation 

Enduring Freedom (hereinafter ‘‘OEF’’) and Operation Iraqi Freedom (hereinafter ‘‘OIF’’) as additional outreach workers for readjustment counseling and related mental health services for veterans; clarifies the immediate family members eligible for bereavement counseling to include parents of an Armed Forces member 

who dies in active service duty; provides that bereavement counseling may be provided through the facilities and personnel of Vet 

Centers; and authorizes expenditures in Fiscal Year 2006 for the 

provision of readjustment counseling and related mental health 

services at veterans’ facilities. The bill was referred to the Committee on Veterans’ Affairs. 

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COMMITTEE HEARINGS

On June 9, 2005 the Committee held hearings on, among other 

bills, S. 716, S. 1177, S. 1180, S. 1189, and S. 1190. Testimony was 

heard from: The Honorable R. James Nicholson, Secretary of Veterans Affairs, The Honorable Jonathan B. Perlin, VA’s Under Secretary for Health, and The Honorable Tim McClain, VA’s General 

Counsel; Mr. Donald Mooney, Assistant Director, The American Legion; Mr. Dennis Cullinan, Director of National Legislative Service, 

Disabled American Veterans; Mr. Adrian Atizado, Assistant National Legislative Director, Disabled American Veterans; Mr. Carl 

Blake, Associate National Legislative Director, Paralyzed Veterans 

of America; and Mr. Richard Jones, AMVETS. 

COMMITTEE MEETING

After carefully reviewing the testimony from the foregoing hearing, the Committee met in open session on September 15, 2005, 

and voted by unanimous voice vote to report S. 716, without 

amendment, favorably to the Senate. 

SUMMARY OF THE COMMITTEE BILL AS REPORTED

S. 716, as reported (hereinafter the ‘‘Committee bill’’), consists of 

changes to current law as summarized below: 

1. Authorize the employment of up to 50 veterans of Operation Enduring Freedom and Operation Iraqi Freedom to provide outreach to veterans regarding availability of readjustment counseling and related mental health services, and to terminate the employment duration limitation that currently applies to these employees under section 1712A of title 38, 

United States Code (section 2); 

2. Clarify the immediate family members eligible for bereavement counseling to include parents of an Armed Forces 

member who dies in active service duty (section 3); 

3. Authorize the appropriation of $180,000,000 for Fiscal 

Year 2006 for readjustment counseling and related mental 

health services in Vet Centers (section 4). 

BACKGROUND AND DISCUSSION

Section 2.—Expansion of Outreach Activities of Vet Centers 

The Department of Veterans Affairs administers many programs 

and services aimed at addressing the transitional and readjustment 

needs of veterans returning from combat or theaters of war. Congress authorized VA to provide readjustment counseling services to 

veterans in 1979. VA then developed Vet Centers to meet the recognized needs of Vietnam era veterans experiencing readjustment 

problems. These community-based Vet Centers have continued 

since that time to provide various counseling, outreach, and referral services to eligible veterans. Most recently, in April 2003, eligibility for care was extended to veterans of OEF, OIF, and subsequent operations within the Global War on Terrorism (hereinafter 

‘‘GWOT’’). 

The 207 Vet Centers across the country are staffed by small 

interdisciplinary service teams, with more than 65 percent of staff 

being veterans themselves. To increase outreach forces to the growVerDate Aug 31 2005 05:55 Nov 22, 2005 Jkt 049010 PO 00000 Frm 00002 Fmt 6659 Sfmt 6602 E:\HR\OC\SR180.XXX SR180
3 

ing number of OEF/OIF veterans needing services, VA authorized 

the Vet Center program to hire 50 veterans in February of 2004 

to provide outreach to fellow GWOT veterans. These coordinators 

are fully trained and briefed on the mission of the Vet Centers and 

on the readjustment services available to veterans. These coordinator positions were authorized by VA for a three year period to 

reach out to veterans and veteran family members in the community. In FY 2005, the cost to fully staff the 50 positions was $2.5 

million. 

Committee bill 

The Committee bill would authorize 50 additional veterans of 

OEF and OIF to perform outreach efforts for Vet Centers. Under 

the Committee bill, these veteran-employees may be assigned to 

any Vet Center deemed appropriate by the Secretary. Also under 

the Committee bill, outreach coordinators would not be subject to 

VA’s stipulation that these positions be subject to only three years 

of hiring authority. 

The need for additional outreach coordinators was also addressed 

by the Department of Veterans Affairs. Shortly after introduction 

of S. 716, VA announced that it would hire 50 additional outreach 

workers for Vet Centers. The intentions were echoed by VA at the 

Committee’s legislative hearing on June 9, 2005, when Secretary 

Nicholson in his testimony stated, ‘‘. . . .last year VA employed 

and trained an additional 50 veterans from the ranks of those recently separated from OEF/OIF to work in Vet Centers providing 

outreach, and we have committed to hiring an additional 50 veterans this year.’’ Despite this, the Committee still finds a need to 

legislate in this area, to ensure that these positions will remain for 

some time. 

The Committee bill received support from various veteran service 

organizations. In testimony given by the Veterans of Foreign Wars, 

Dennis Cullinan referred to these outreach workers and said, ‘‘Who 

better to explain service and help ease their transition than someone who served alongside them, can relate to their experiences, and 

has already navigated VA’s many benefits programs?’’ 

The number of returning OEF/OIF servicemembers continues to 

grow, therefore the number of outreach workers needed must be increased to provide veterans with the services they need. 

Section 3.—Clarification and Enhancement of Bereavement Counseling 

In August of 2003, the Secretary of Veterans Affairs enabled Vet 

Centers to provide bereavement counseling services to immediate 

family members of servicemembers who died while defending their 

country. Family members of servicemembers who die while on active duty, as well as federally activated Reserve and National 

Guard personnel, can seek comfort and help through Vet Centers. 

However, it is currently unclear whether or not a bereaved parent 

can receive such services, which is a significant problem as many 

of those who die on active service have surviving parents. Furthermore, while the Secretary allowed the Vet Centers to provide bereavement counseling to parents of servicemembers who die in 

combat, it is unclear if the law allows such counseling. 

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Through the Vet Centers’ bereavement counseling services, family members dealing with the emotional and psychological stress of 

losing a loved one in combat are able to receive the assistance and 

support they need right in their community. Outreach efforts, referral services, and other transitional services are provided through 

the bereavement counseling program to these family members. 

The first bereavement counseling case was initiated in December 

2003 and the roster of cases has unfortunately grown since then. 

From briefing information on Vet Centers provided to the Committee, it was reported that Vet Centers served 342 family members. Recorded casualty cases seen through Vet Centers include a 

total of 233 cases, with 169 in-theater casualties. These cases are 

referred to Vet Centers through various sources, mainly self referrals, referral from Transition Assistance Programs, and also from 

Casualty Assistance Officers. The casualty type ranges from those 

killed in action to suicide and extends through various branches of 

service, with more than half from the Army. 

In February 2005, the Washington Post printed an article that 

detailed a mother’s experience after her son was killed in Iraq and 

how she finally felt relief at an unexpected place, a Vet Center. The 

author painted a clear picture of the distress that surviving family 

members endure as a result of the death of a beloved soldier and 

how some are able to find solace through the Vet Center bereavement counseling program. However, despite her loss and the difficulty of recovering from her son’s death, the mother in this story 

is not currently guaranteed access to bereavement counseling services. 

Committee bill 

The Committee bill would provide express authority to Vet Centers to provide bereavement counseling to all immediate family 

members. The bill would also ensure the furnishing of bereavement 

counseling services to parents by defining them as members of the 

immediate family when a servicemember dies in active service. 

Section 4.—Funding for Vet Center Program 

For more than two decades, Vet Centers have provided counseling and referral services to an expanded veteran population. All 

care is conducted in a safe and confidential environment and in a 

manner respective of the culture of veterans. 

Vet Centers are staffed by a total of 943 full time employees, of 

which over 65 percent are veterans. Having these community-based 

centers staffed by veterans, who understand and have themselves 

had similar experiences with the difficulties of post-war transition, 

supports the statement of purpose for the Vet Centers. 

Staff workload through January 2005 included a total of 14,692 

OEF/OIF veterans and families served by Vet Center staff. Of 

these, 2,590 veterans were seeking treatment for post-traumatic 

stress disorder (hereinafter ‘‘PTSD’’), with projections of OEF/OIF 

PTSD clients estimated to increase to 4,752 in FY 2005 from 1,569 

in FY 2004. The number of visits from OEF/OIF returning 

servicemembers increased from 2,450 in FY 2003 to 18,819 in FY 

2004 and is projected to further increase to 31,068 this year. Vet 

Center staff has also provided vital services to over 7,000 

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servicemembers exclusively at demobilization sites and transitional 

assistance program (hereinafter ‘‘TAP’’) briefings. 

The workload demonstrates that Vet Centers have provided 

added services to a growing number of servicemembers and families but have not seen a corresponding increase in funding. Indeed, 

funding levels have remained relatively stagnate with increases reflecting solely cost of living adjustments (with the exception of a 

small funding increase in FY 2005). Vet Centers received $83.1 million in FY 2003; $87.4 million in FY 2004; and $94 million in FY 

2005. Funding levels for FY 2005 were increased specifically to 

fund particular initiatives and not to compensate for the growing 

number of services delivered subsequently over the years. 

Committee Bill 

Considering that Vet Centers have provided services to an increasing population of returning servicemembers during the past 

three years, the Committee bill would address the need for additional resources. 

These additional funds would also augment Vet Centers in underserved rural communities and would expand the capacity for 

these centers to provide readjustment services to those veterans 

who may struggle to obtain access because they live in a remote 

area. Surviving immediate family members of those servicemen 

who paid the ultimate price will be able to find solace through the 

Vet Centers’ bereavement counseling program. Vet Centers would 

be able to hire more bereavement counselors to provide services for 

those who must endure the pain of losing a family member in combat. 

In addition, Vet Centers could more readily participate in the 

transition efforts of the Department of Defense (hereinafter DoD’’). 

The Vet Centers’ twenty five year history of working with combat 

veterans to overcome the stigma associated with seeking professional assistance, plus the Vet Centers’ understanding of military 

culture and experience, means that the Centers are a perfect fit to 

assist DoD with its counseling programs. 

The Committee Bill would authorize $180 million for the Department of Veterans Affairs in fiscal year 2006 for the sole purpose 

of increased funding for Vet Centers. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

In compliance with paragraph 11(a) of rule XXVI of the Standing 

Rules of the Senate, the Committee, based on information supplied 

by the CBO, estimates that enactment of the Committee bill would, 

relative to current law, increase spending by $102 million in 2006 

and by about $185 million over the 2006–2010 period. Enactment 

of the Committee bill would not affect direct spending or receipts, 

and would not affect the budget of state, local or tribal governments. 

The cost estimate provided by CBO, setting forth a detailed 

breakdown of costs, follows: 

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SEPTEMBER 28, 2005. 

Hon. LARRY E. CRAIG, 

Chairman, Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

DEAR MR. CHAIRMAN. The Congressional Budget Office has prepared the enclosed cost estimate for S. 716 the Vet Center Enhancement Act of 2005. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Michelle S. Patterson. 

Sincerely, 

DOUGLAS HOLTZ-EAKIN, 

Director. 

Enclosure. 

S. 716—Vet Center Enhancement Act of 2005 

S. 716 would authorize the appropriation of $180 million in 2006 

for veterans’ readjustment counseling and related mental health 

services and to carry out the specific requirements of this bill. The 

bill also would require the Secretary of the Department of Veterans 

Affairs (VA) to hire up to 50 additional veterans of Operation Enduring Freedom or Operation Iraqi Freedom to provide outreach on 

the availability of counseling services. Finally, the bill would clarify 

that parents of a member of the Armed Forces are eligible for bereavement counseling. 

CBO estimates that implementing this bill would cost $102 million in 2006 and about $185 million over the 2006–2010 period, assuming appropriation of the authorized and estimated amounts. 

Enacting the bill would not affect direct spending or receipts. 

S. 716 contains no intergovernmental or private-sector mandates 

as defined in the Unfunded Mandates Reform Act (UMRA) and 

would not affect the budgets of state, local, or tribal governments. 

The estimated budgetary impact of S. 716 is shown in the following table. For this estimate, CBO assumes the bill will be enacted early in fiscal year 2006. The costs of this legislation fall 

within budget function 700 (veterans benefits and services). 

TABLE 1.—ESTIMATED BUDGETARY IMPACT OF S. 716 

By fiscal year, in millions of dollars— 

2005 2006 2007 2008 2009 2010 

SPENDING SUBJECT TO APPROPRIATION 

Spending Under Current Law for Veterans’ Readjustment Counseling Services: 

Budget Authority 1 ................................................... 94 0 0 0 0 0 

Estimated Outlays ................................................... 85 8 0 0 0 0 

Proposed Changes: 

Estimated Authorization Level ................................. 0 180 3 3 3 3 

Estimated Outlays ................................................... 0 102 30 47 3 3 

Spending Under S. 716 for Veterans’ Readjustment 

Counseling Services: 

Estimated Authorization Level 1 .............................. 94 180 3 3 3 3 

Estimated Outlays ................................................... 85 110 30 47 3 3 

1 The 2005 level is the amount appropriated for that year. 

Section 4 would authorize the appropriation of $180 million for 

fiscal year 2006 for veterans’ readjustment counseling and related 

mental health services provided through VA’s Vet Centers and to 

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carry out the specific requirements in this bill. Because the authorized amount is almost twice the current budget amount for these 

programs, CBO expects that it would take VA about three years to 

increase the size and scope of these counseling programs to the 

level authorized for 2006. Thus, CBO estimates that implementing 

this provision would cost $102 million in 2006 and about $180 million over the 2006–2008 period, assuming appropriation of the authorized amount. 

Section 2 would require VA to hire up to 50 additional veterans 

of Operation Enduring Freedom or Operation Iraqi Freedom to provide outreach on the availability of counseling services. The provision would remove any current limits on the duration of the employment for such hires, and would direct VA to employ these veterans in a career conditional status. According to VA, most of the 

veterans currently employed in this program are hired as general 

schedule (GS) grade 7 employees. Assuming that these veterans 

would all be hired by the end of 2006, CBO estimates that employing these additional veterans would cost about $1 million in 2006 

and $3 million annually thereafter. 

Section 3 would clarify that parents of members of the Armed 

Forces who die while on active duty are eligible for bereavement 

counseling from VA. According to VA, it already provides such 

counseling through existing resources. In fact, VA has counseled 

about 600 family members, including parents, since the program to 

provide bereavement counseling to family members of active-duty 

servicemembers began about two years ago. Thus, CBO estimates 

that implementing this provision would have no additional cost. 

S. 716 contains no intergovernmental or private-sector mandates 

as defined in UMRA and would not affect the budgets of state, 

local, or tribal governments. 

The CBO staff contact for federal costs is Michelle Patterson. For 

impact on state, local, and tribal government, the CBO staff contact 

is Melissa Merrell. The CBO staff contact for private sector impact 

is Joshua Lee. This estimate was approved by Peter H. Fontaine, 

Deputy Assistant Director for Budget Analysis. 

REGULATORY IMPACT STATEMENT

In compliance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the Committee on Veterans’ Affairs has made 

an evaluation of the regulatory impact that would be incurred in 

carrying out the Committee bill. The Committee finds that the 

Committee bill would not entail any regulation of individuals or 

businesses or result in any impact on the personal privacy of any 

individuals and that the paperwork resulting from enactment 

would be minimal. 

TABULATION OF VOTES CAST IN COMMITTEE

In compliance with paragraph 7 of rule XXVI of the Standing 

Rules of the Senate, the following is a tabulation of votes cast in 

person or by proxy by members of the Committee on Veterans’ Affairs at its September 15, 2005 meeting. On that date, the Committee, by unanimous voice vote, ordered S. 716 reported favorably 

to the Senate. 

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AGENCY REPORT

On June 9, 2005, Secretary of Veterans’ Affairs, the Honorable 

James Nicholson, appeared before the Committee on Veterans’ Affairs and submitted, testimony on, among other things, S. 716. Excerpts from this statement are reprinted below: 

STATEMENT OF THE VIEWS OF THE 

ADMINISTRATION 

STATEMENT OF THE HONORABLE JAMES NICHOLSON

SECRETARY OF VETERANS’ AFFAIRS

Good Afternoon Mr. Chairman and Members of the Committee: 

I am pleased to be here this morning to present the Department’s views on several different bills being considered 

by the Committee. They cover a wide range of subjects related to VA’s provision of health care services to veterans. 

S. 716

I next turn to S. 716, which deals with VA’s outreach to 

veterans returning from OEF and OIF regarding services 

they can receive from VA’s Readjustment Counseling Program and other VA mental health programs. The bill 

would specify that VA may provide bereavement counseling to the families of those who die in the active military service. We fully support the intent of S. 716, and in 

fact are currently carrying out most of its requirements. 

That being the case, enactment of the bill is unnecessary. 

Specifically, S. 716 would require that VA employ 50 

new individuals, all of whom must be veterans of either 

OEF or OIF, to provide outreach to other veterans when 

they return from service in those operations. As we have 

previously advised the Committee, last year VA employed 

and trained an additional 50 veterans from the ranks of 

those recently separated from OEF/OIF to work in Vet 

Centers providing outreach, and we have committed to hiring an additional 50 veterans this year. The 50 persons 

hired last year were all given career-conditional appointments. That means that these veterans can expect to retain their employment. This bill further provides that any 

limitation on the duration of employment for these employees is terminated, and it would require that the additional 

50 appointments that we make this year also receive career-conditional appointments. The latter provision is imprudent. 

We do not intend to terminate any of the positions in 

question, but at the same time we do not expect that the 

conflicts in Central Asia will continue indefinitely. We 

hope the day will come when we will no longer have to undertake the outreach contemplated by this bill. If the need 

for these positions ends at some point in the future, the 

employees would likely move into other positions in VA, or 

be eliminated by attrition. However, to permit wise and efficient stewardship of the Department, we urge amendVerDate Aug 31 2005 05:55 Nov 22, 2005 Jkt 049010 PO 00000 Frm 00008 Fmt 6659 Sfmt 6969 E:\HR\OC\SR180.XXX SR180
9 

ment of this legislation so as not to restrict the nature and 

duration of the appointments we make. 

S. 716 would also more explicitly provide that VA has 

authority to provide bereavement counseling for the families of deceased active duty servicepersons, including parents, and that VA can provide the counseling in Vet Centers. In August 2003, former Secretary Principi directed 

that Vet Centers develop a program to provide such bereavement counseling, and we are now actively providing 

that service. In the operation of that program, we have 

permitted counseling various members of the family, including the parents of the deceased. Since the inception of 

the program, the families of over 365 servicepersons who 

have died on active duty have been referred to the Vet 

Centers for counseling assistance, and the Centers have 

provided services to over 555 family members. The average 

number of counseling sessions provided to each family 

member has been six. Program clinical experience has 

been that most families need a supportive therapeutic environment to assist them in processing the immediate 

stages of grief and to stabilize their situation sufficient to 

mobilize their own coping resources. 

Finally, S. 716 would authorize $180 million to be appropriated for the provision of readjustment counseling and 

related mental health services through Vet Centers. In the 

current fiscal year VHA allocated a total of $94 million for 

all Readjustment Counseling Service activities. We estimate that the additional services that this bill would direct, and that we are in fact already implementing, will require only about $8 million. There is no necessity or justification for nearly doubling the amount we spend on Readjustment Counseling Service. 

* * * * * * * 

CHANGES IN EXISTING LAW MADE BY THE COMMITTEE BILL, AS

REPORTED

In compliance with rule XXVI paragraph 12 of the Standing 

Rules of the Senate, changes in existing law made by the Committee bill, as reported, are shown as follows (existing law proposed 

to be omitted is enclosed in black brackets, new matter is printed 

in italic, existing law in which no change is proposed is shown in 

roman): 

TITLE 38, UNITED STATES CODE 

* * * * * * * 

CHAPTER 17—HOSPITAL, NURSING HOME, 

DOMICILIARY, AND MEDICAL CARE 

* * * * * * * 

10 

Subchapter VIII—Health Care of Persons Other Than 

Veterans 

* * * * * * * 

§ 1783. Bereavement counseling 

* * * * * * * 

(b) DEATHS IN ACTIVE SERVICE. (1) The Secretary may provide bereavement counseling to an individual who is a member of the immediate family of a member of the Armed Forces who dies in the 

active military, naval, or air service in the line of duty and under 

circumstances not due to the person’s own misconduct. 

(2) For purposes of this subsection, the members of the immediate 

family of a member of the Armed Forces described in paragraph (1) 

include the parents of such member. 

(c) Provision of Counseling Through Vet Centers. Bereavement 

counseling may be provided under this section through the facilities 

and personnel of centers for the provision of readjustment counseling and related mental health services under section 1712A of 

this title. 

[(c)] (d) Bereavement counseling defined. For purposes of this 

section, the term ‘‘bereavement counseling’’ means such counseling 

services, for a limited period, as the Secretary determines to be 

reasonable and necessary to assist an individual with the emotional and psychological stress accompanying the death of another 

individual. 

Æ